Opioids are a class of drugs naturally found in the opium poppy plant and that work in the brain to produce a variety of effects, including the relief of pain with many of these drugs. Opioids can be prescription medications often referred to as painkillers, or they can be so-called street drugs, such as heroin.
Many prescription opioids are used to block pain signals between the brain and the body and are typically prescribed to treat moderate to severe pain. In addition to controlling pain, opioids can make some people feel relaxed, happy or “high,” and can be addictive. Additional side effects can include slowed breathing, constipation, nausea, confusion and drowsiness.
However, opioid use is increasing in pregnancy as well as the general population. A “Five things to know about …” practice article on opioid disuse in pregnancy in Canadian Medical Association Journal provides information on how to manage this vulnerable population.
- Opioid use and opioid use disorders in pregnancy are rising.
- Guidelines support universal screening for drug use, including opioids, by prenatal care providers.
- Opioid agonist therapy is the standard of care for opioid use disorders in pregnancy, along with counselling and mental health supports. Pregnant women with an opioid use disorder should be offered timely access to opioid agonist therapy.
- Neonatal opioid withdrawal syndrome is best managed by keeping mothers and infants together after delivery. Breastfeeding should be encouraged in women who are stable on opioid agonist therapy, for whom there are no concerns about ongoing drug use.
- Ongoing support in the postpartum period is essential, as women with opioid use disorders are at increased risk of fatal overdose in the first year postpartum.